NPIMap

Organization Active NPI

Manuel M. Contreras DDS a Professional Dental Corporation

  • Dental Clinic/Center
  • Stockton, CA
National Provider Identifier
1295368561
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MANUEL M. CONTRERAS DDS A PROFESSIONAL DENTAL CORPORATION
Practice address
1701 W March LN Ste B
Stockton, CA 95207-6416
Phone
(209) 463-6130
Fax
(209) 463-6297
NPI assigned
Feb 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Manuel M Contreras, D.D.SNPI 1962699686
Title
Owner
Phone
(209) 463-6130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1701 W March LN Ste B
Stockton, CA 95207-6416

Mailing address

1701 W March LN Ste B
Stockton, CA 95207-6416
Phone (209) 463-6130

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL yola.contrerasfamilydental@gmail.com Direct

National Provider Directory

National Provider Directory

Locations

1701 W March Ln
Ste B
Stockton, CA 95207
Phone (209) 463-6130

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1295368561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W MARCH LN STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076416",
            "telephone_number": "209-463-6130",
            "fax_number": "209-463-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W MARCH LN STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076416",
            "telephone_number": "209-463-6130",
            "fax_number": "209-463-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL M. CONTRERAS DDS A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-463-6130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "yola.contrerasfamilydental@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 W March Ln Ste B",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952076416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.